Archive for Adult ADHD

The Individuality of People with ADHD

fingerprint 150x150 The Individuality of People with ADHDWhen you ask someone what they think of when they hear the term “ADHD”, they often say that they picture a boy who is hyperactive. And that’s accurate – there are some boys with ADHD who are hyperactive.

But ADD/ADHD can go far beyond boys who are hyperactive.

There are also boys who are inattentive, girls who are daydreamers, young men who get angry easily, young women who are “too emotional”, and a whole range of other different ‘presentations’ of how people seem when they have ADD or ADHD.

In my office, after completing an assessment, I discuss with a family that their child meets criteria for ADHD (if they do) and I explain more about it. It’s quite a common occurrence for the parent to say something like: “I know about ADHD because my other child has it (or my nephew has it; or I’m a teacher and I’ve had kids in my class with it), and I just don’t see my child having the same thing as the other kid(s) that I know with ADHD.”

I then go on to explain how ADHD can ‘look different’ in different people, and I explain how it is manifesting in their child.

While I’ve always known that ADHD can seem different from one person to another, the extent of the individual nature of ADHD really hit home recently when I was reading to prepare for a presentation to teachers. In the book ADHD in the Schools by Dupaul and Stoner, this point was made very clear. Before sharing Dr. Dupaul and Dr. Stoner’s insights, let me just give a brief overview of how ADHD is diagnosed with the DSM criteria.

The DSM-IV-TR (The Diagnostic and Statistical Manual of the American Psychiatric Association) lists 9 symptoms of inattention, and 9 symptoms of hyperactivity/impulsivity. To meet the criteria for ADHD, one has to have at least 6 symptoms on one or both of these two lists (inattention or hyperactivity/impulsivity).

If one has at least 6 symptoms of inattention, and fewer than 6 symptoms of hyperactivity/impulsivity, then one is diagnosed with ADHD- Inattentive Subtype.

If one has at least 6 symptoms of hyperactivity/impulsivity, and fewer than 6 symptoms of inattention, then one is diagonsed with ADHD- Hyperactive Impulsive Subtype.

If one has at least 6 symptoms on BOTH lists, then one has ADHD- Combined Subtype.

So, to meet criteria for ADHD Combined Type, one has to have at least 12 out of 18 symptoms of ADHD. Of course, one could have 13 symptoms, or 14, etc.

In their book ADHD in the Schools, Doctors DuPaul and Stoner write:

“There are at least 7,056 possible combinations of 12 out of 18 symptoms that could result in a diagnosis of ADHD-Combined Type.”

7,056 different combinations of ADHD symptoms!

No wonder there isn’t one stereotype for kids/teens and adults with ADHD.

And this only relates to the combined type of ADHD. There would be more combinations if we added inattentive only, or hyperactive impulsive only.

And this is just based on the combination of symptoms alone. If we go a little deeper, and look at the individual, and take into account things like:

  • Ethnic and cultural background
  • Personal life experiences
  • Likes and dislikes
  • Strengths and skills people have
  • Weaknesses and challenges people struggle with
  • Personality traits
  • The society they’ve grown up in…
  • And a whole lot of other varilables

It’s no wonder that not everyone with ADD/ADHD seems to ‘look’ the same, and appear to have the same type of ADHD.

Are there similarities between individuals with ADHD? Of course there are. To meet criteria for the diagnosis, one has to have a relevant number of symptoms, and there are clinical patterns which can emerge.

However, don’t ever dismiss ADHD as a diagnosis just because that one person doesn’t appear the way you think ADHD should look . That person is just an individual with ADHD (with all of their unique individuality).

I hope that after reading this blog post, you’ll share this message with other people about ADHD. One of the first steps to destigmatize and to improve understanding about ADHD in society at large is for people to have the facts. And if we can help people to realize that not every person with ADHD is a hyperactive boy, and we open people’s minds to the fact that people with ADHD can be either gender, they can have a whole range of different symptoms, life experiences and levels of achievement in life, then we can do a lot of good out there.

And once someone has been diagnosed with ADHD, it is important that we focus on their differences and strengths to help them to achieve their best outcomes.

Please share your thoughts and comments below.

Best,

Dr. Kenny

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Britney Has ADHD

britneyspearscropped Britney Has ADHD

Britney Spears has ADHD (picture from Wikipedia.org)

It has just been reported that Britney Spears has ADHD. The Grammy winning pop star, who holds Guinness World Records, and has her own Star on the Walk of Fame has now shared that she has ADHD.

Britney has taken on the role of a judge on the singing reality show “The X Factor”, and she is now currently filming for the show. During the filming of auditions, Britney reportedly needed to take breaks, and the explanation was that she has ADHD, and that she had to take breaks during the long filming sessions.

The reports also go on to explain that Britney was diagnosed with ADHD when she was young, and used to take medication for it. Her doctors apparently have now forbidden her from taking ADHD medication for reasons related to other mental health concerns. Here is a link to one of the news reports about this story.

Now that Britney has come forward and shared her diagnosis of ADHD, she joins other celebrities like: Howie Mandel, Ty Pennington, Adam Levine, Michael Phelps, Karina Smirnoff and many others.

I personally view this as a brave and helpful admission. Millions of kids and teens get diagnosed with ADHD, and they feel that they are disordered, and they wonder if they will have a positive future because of their “Disorder”. Having celebrities come forward to share their diagnosis helps kids to realize that they can be successful even though they have ADHD.

While I view Britney’s disclosure as a positive, I have come across some comments on social media sites (which I don’t want to support with a link right now…) who say that Britney is “blaming” her behavior on ADHD, and how awful is that. They are suggesting that she is acting like a diva, and using ADHD as an excuse.

Before responding to this, I’d like to share that I have no direct knowledge on Britney’s diagnosis or medical care – I only know what I’ve read online. And saying that – here’s my response: Britney apparently disclosed to her employer (Simon Cowell) before signing on for the show that she has ADHD, cannot take medication for it, and needs to take breaks at times because of it. Simon apparently agreed to this before hiring Britney. Britney can’t take medication for ADHD, and instead she is using strategies to help herself to function well. And let’s remember – although an ‘audition show’ makes it seem like 1 hour for each city (i.e. the LA auditions only seem to take 1 hour), in fact, they are filming for very long days… (and of course there is much more involved – make up, lighting, direction, breaks, etc.) They just edit it to seem short for us – the viewers.

In my understanding of the situation, Britney is acknowledging her challenges, putting strategies and supports in place, and working to function in the best way that she can. I think that is a great model for others to learn from and to emulate. I would not try to tear her down for being a diva and blaming it on ADHD.

The reality is that ADHD medication is helpful for Adult ADHD, and it is not the whole solution. There is some research that shows that most of the time, ADHD medications do not fully treat the symptoms of adult ADHD. So, it is very important to use strategies and to develop skills to improve functioning with ADHD. This is even more important if someone is unable to take medication.

Why can’t Britney take medication for ADHD?

There aren’t any reports that I’ve read which explain this in more detail. One news report said that she can’t take medication for ADHD because of mental health issues. While I don’t know what these are for Britney, it is possible that she has had one of these challenges: intolerable side effects from ADHD medication; mood instability from ADHD medications (i.e. depression or induction of hypomania or mania), sleep disruption, significant decreased appetite, etc. In other words, I’m guessing. I’m sure she has expert and capable doctors.

The take away I encourage you to get from this is: Britney is a talented star, who has ADHD, is using strategies to manage it because she can’t take medication (on doctor’s orders). That’s a great example for all of us.

What impact do you think this admission will have for you, or your kids with ADHD, or the people you work with (if you’re a professional working with people with ADHD)?

Please share your thoughts or comments below.

Best,

Dr. Kenny

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Why I Like NBC’s “The Voice” and Its ADHD Lessons

230px TheVoiceTitleCard Why I Like NBCs The Voice and Its ADHD Lessons

The Voice (picture from wikipedia.org)

In general, I’m not one for reality shows, especially not ones about singing (maybe it’s because I can hardly carry a tune…). But, something about the promos for “The Voice” caught my attention. This season (season 2), I caught a couple of the early shows – with the blind auditions, and I’m now watching the final shows (to see who’s going to win!).

As a doctor who specializes in ADHD, I think “The Voice” has some important lessons for parents of kids and teens with ADHD, as well as Adults with ADHD, and I’ll share them with you here.

If you’re not familiar with “The Voice”, it has some interesting twists on a singing competition show.

Firstly, on this show, the judges aren’t just judges, they’re coaches. The four coaches are: Christina Aguilera, Adam Levine, Ceelo Green and Blake Shelton. While they do ‘judge’ throughout the competition, they each choose contestants, and they coach them. The coaches help to develop their singer’s talents, and help them to do the best they possibly can during the show. Through the course of the show, the contestants get great advice, training and encouragement from their coaches, and viewers can see how close the relationships develop during the course of the show.

ADHD Lesson: getting coaching from people who have been where you are, and can help you to go where you need to go, can be life altering. When it comes to ADHD treatment, there are doctors, therapists and other health professionals, and now there are also expert ADHD Coaches – who can help you in many ways as well. To find out more about coaching, visit the ADHD Coaches Organization.

Secondly, when the contestants audition, the judges are ‘blind’ to what they look like. The judges have their chairs turned backward, and they can only hear the singer’s voice when they’re deciding if they want to choose them for their team. This is a real twist, because the judges have to choose the contestants based solely on their voice, and not on how they look. We all know that certain people look like stars, and many people don’t. In some reality shows, a person’s look has a big impact on whether they’re chosen. In this show, people are chosen based on their own merit. Although the world doesn’t always work that way, it’s great to see it happen.

ADHD Lesson: Many times, kids, teens and even adults with ADHD are judged negatively because of their ADHD symptoms (i.e. they’re too inattentive, or too impulsive in a situation). We need to help people to see ADHDer’s talents and actual abilities. Often, they’re incredibly talented in particular areas. Hopefully, people can look past ADHD to see the talent, and hopefully, good treatment for ADHD will help people to develop their talents, and share them well with others.

Thirdly, I love how many contestants and participants make so many sacrifices to pursue their dream of singing. Early in the season, there were many people who left their jobs, left a semester at college or made other sacrifices to be able to attend the auditions. And not all of them even got chosen for the show! From my perspective, even if they weren’t selected for the show, those participants were hugely successful for choosing to pursue their dreams.
To quote Zachary Scott: “As you grow older, you’ll find the only things you regret are the things you didn’t do.” (source Brainyquote.com)

Fourthly, many of the show’s contestants/singers are singing for reasons which are much bigger than just themselves and their dreams. Many are singing to stay true to themselves and to support their families; to honor and thank those that believed in them; and Erin Willette even stayed in the show and sang when her father passed away in between the auditions and the live battle rounds. Although she was quite emotional about it, she knew she had her father’s love and support, and both of her parents (and her family) wanted her to pursue her dream. What a gift her family gave her, and what a gift she gave her dad – for him to see her pursuing her dream (and succeeding!) in his final days.

ADHD Lesson: Combining points 3 and 4, we learn that it’s important to pursue our dreams, and to work for a reason bigger than ourselves.
For many of us, getting through the day to day and week to week can be challenging (especially when dealing with ADD/ADHD in ourselves or our children). And it may seem selfish, indulgent, or just absurd to take the time to dream again, or to connect with our long lost dreams. And it is still important to do! Why do you get excited when you see an underdog win a gold medal in the Olympics? Why do we love hearing the back-story of someone who goes on to do great things? Because it inspires us. It touches us deep insider – where we have our dreams, goals and our greatness. And when we hear their story, we briefly remember our greatness. Make a decision to pursue your dreams again. You don’t have to quit your job, or move to Los Angeles right now, but if you love music – start playing your guitar again, or start singing again. Maybe there’s a local ‘open mic’ night, and you can enjoy connecting with your creative side again. Or the church choir would love to have your voice join them…

When it comes to helping to motivate kids/teens and adults with ADHD, it’s important to have a great ‘reason why’. People with ADHD don’t pursue goals ‘just because’. The daily, mundane, boring (and seemingly irrelevant tasks) don’t get done just because they should. When there is a great reason why – that motivates ADHDer’s to do great things. So, think about some great reasons why. And if you have a child or teen with ADHD, take the time to help them to find the reason why things are important (like Math homework that they think will never be relevant in their life… try putting a dollar sign in front of the numbers :-)) With a strong ‘reason why’, the contestants in “The Voice” are more compelling, and in real life, if we have a strong ‘reason why’, we work much harder to pursue what’s important to us.

Finally, one of the reasons that I love “The Voice” is the huge respect I have for Adam Levine, the singer from Maroon 5. Not only is Adam a great singer, a great coach on the show, and the coach who won in season 1 of “The Voice”, he is also an adult with ADHD.

Not only is Adam an adult with ADHD, he is one who is sharing it widely, and using his position of celebrity to help others who have adult ADHD. Up to 60-70% of kids/teens with ADHD still have it as adults. However, most believe that they have outgrown it, and don’t need any more help. Adam’s message is simple – you may not have outgrown it, and you should review it with your doctor, and get the help you need. Recently, Adam has worked with Shire to create the “Own It Project” target=”_blank”, which encourages adults with ADHD to ‘own their ADHD’, and if that’s you – you can submit your story to qualify to win a prize.

Adam is doing a great thing to raise awareness of adult ADHD, decrease stigma, and to help others. And for that, I’m grateful.

When it comes down to it, I don’t mind whether you watch “The Voice”, or whether you ever will. Hopefully, these reflections will help you in your life (or your loved one’s life) by taking the messages and applying them to your situation.

Please share your thoughts and comments below.

Best,

Dr. Kenny

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Practice Gratitude Regulary

This past week, it was US Thanksgiving. When it’s Thanksgiving, people (generally) have a great time with friends and family, and have a wonderful, satisfying meal together.

And… most people take some time to consider what they are thankful for.

I am thankful for so many things. Including:

  • My Family and Friends
  • My Health
  • My profession, and the ability I have to help people on a day to day basis
  • The fact that I was born at the time I was (we live in amazing times, with incredible opportunities)
  • The fact that I was born in Canada (it may get cold here, but it is one of the best countries in the world, in my opinion)

And I’m also thankful to you - my blog reader or subscriber – because you’ve chosen to share your journey with ADD/ADHD with me, and you allow me to come onto your computer screen, or into your email inbox to share my thoughts, perspective and advice. I also really appreciate your comments, feedback and participation in the dialogue.

Now – I love Thanksgiving, and I think it is a wonderful yearly ritual.

And I encourage you to practice gratitude more regularly than once a year.

When I say ‘practice gratitude’, I mean that I encourage you to take a few moments, and quiet yourself down. Get comfortable, slow your breathing, and even close your eyes. Think about who and what you are grateful and thankful for. And then feel the feelings of gratitude and love for what you are focusing on. This exercise can take just a moment, and it can be tremendously helpful for you.

When you achieve a state of gratitude (with true feeling and emotion), it changes how you feel, as well as how you interact with the world and others. This can help you in our stressed out, overly busy world – especially if you have ADD/ADHD yourself, or if it’s in your family.

I encourage you to practice gratitude regularly – ideally daily.

What do you think? Please share your thoughts in the comments below.

Best,

Dr. Kenny

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Adult ADHD: Surviving The Holidays

The Holidays can be a very stressful time for everyone – but it’s especially difficult for Adults with ADD/ADHD.

There are so many details to take care of, including:

  • Decorations
  • Cards
  • Gifts
  • Events
  • Food…
  • And the list goes on and on…

And the worst part is that many adults with ADD often get overwhelmed, and then down when they feel that they have messed up for yet another year…

Why not start off the holidays with some strategies that can help you out?

Adult ADD Coach: Lynne Edris (from Coaching ADDvantages), can help you with some strategies to help you to do better this holiday season.

Steps to help you out:

First: Watch this video where Lynne shares some specific strategies to help you out:

Second: Join us for the live coaching call on Monday November 21st at 9:15 pm eastern time. Just click here to join the Insiders Membership Site.

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And, we hope you have a great holiday season icon smile Adult ADHD: Surviving The Holidays

Best,

Dr. Kenny

p.s. there are many benefits to being an ‘Insider’. Click here to find out more.

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Adult ADHD Radio Interview

On Sunday September 4, 2011, I was interviewed on WGTK radio on the Dr. Stan Frager show. The interview was all about adult ADHD (with some questions/comments about teen ADHD as well).

Dr. Frager was kind enough to let me share the recording of the radio station with you. You can hear the radio interview here:

Please share any comments below.

You can pick up a copy of Attention Difference Disorder here.
Best,
Dr. Kenny

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15 Signs You May Have Adult ADHD

I wanted to share this great article on the Huffington Post – about 15 signs which may indicate that you have Adult ADHD. As we’ve covered on this blog before, it can often be very hard to get a diagnosis when you are an adult with ADD/ADHD. I think this article can help you out.

You can read it here: 15 Signs You May Have Adult ADHD.

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Faking Adult ADHD?

A recent study recently reported that up to 22% of ADHD adults either fake or exaggerate their symptoms. This may be to get ADHD medication, or higher doses of ADHD medication. You can read more about this here.

In this ‘internet era’, it is very easy for people to spend 20 minutes on google, and know all about the symptoms that are used to diagnose ADHD. This is a risk.

At the same time, there are literally millions of adults with ADHD who can’t find a specialist or doctor who can help them with a proper and thorough diagnosis – to get the help that they really need.

Why do these ‘fakers’ want to get their hands on ADHD medications?

When ADHD medications are taken as prescribed, they are helpful and safe. When they are misused – either by being diverted, or misused, they can be quite problematic. When people misuse them – they may take their own prescriptions in a way that wasn’t prescribed – i.e. they may save us several days of their short acting medication and crush the pills and snort them. By doing this, they cause the medication to get to their brain much more quickly, and they can get a high. Or, they may take stimulant medications late at night to cram for university exams – and this can be medically dangerous. Diversion refers to the situation when people use their medications in other ways – i.e. they sell them, give them to their friends, or find other creative uses for them which are wrong. Diverting stimulant medication is actually illegal. All of this is medically dangerous.

What should happen?

It is very important that doctors do thorough assessments for adult ADHD. They need to gather information about the long term history of the disorder, (hopefully) get information from other sources – including family members, even old report cards – which help to corroborate the diagnosis, etc. If people get a proper diagnosis, then we can ‘cut down’ the fakers from misusing the prescription medications.

The other thing to do is for doctors to use the newer generation of long acting medications. These medications are much less abusable, and tend to have a lower street value because of that.

This is an important issue.

What has your experience been? Please share your thoughts below…

Best,

Dr. Kenny

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Age Activated ADD

This is a humorous video from Youtube about ‘Age Activated ADHD’. Although this is a funny ‘sketch’, it describes what many people with ADD/ADHD feel like when they go about their day.

Watching it can help parents of kids/teens with ADD/ADHD, and spouses of adults with ADD/ADHD understand what is really going on for people who have this condition.

Enjoy!

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Melatonin for Sleep

Many people with ADD/ADHD have problems with sleep. Research shows that about 30-40% of people with ADD/ADHD have sleep problems. Then, some medications can cause insomnia as a side effect which can worsen the sleep problems.

While there are many prescription medications which can help with sleep, people are often reluctant to use another prescription medication to deal with sleep.

Which is why I like to start working on sleep with a natural approach.

Firstly – people need to focus on good ‘sleep hygiene’. Sleep hygiene refers to following good practices around sleep to help to eliminate problems. For example, not having caffeine after mid-day, getting exercise, not watching TV in bed, doing low stimulus activities prior to sleep (i.e. reading) etc. Sleep hygiene can make a difference, but often it’s not enough to help everyone.

The first ‘medicine’ I use to help with insomnia is: Melatonin. Melatonin is a natural supplement that is available ‘over the counter’ – i.e. a prescription is not needed. Our brains naturally make melatonin to help to regulate our sleep-wake cycle.

In the days before electricity, when the sun was up, our brain made no melatonin, and then when it was dark out, our brains made melatonin, telling us that it was time to sleep. Nowadays, it is possible to have artificial light on all the time – with lights, TVs, computer screens, etc. Thus, our brains don’t get a clear message as to when it is night time, and thus many people have sleep wake cycle problems.

Melatonin can be purchased from a pharmacy or health food store. It generally comes in a 3 mg tablets. Sometimes, it comes in liquid, or melt in the mouth forms. Sometimes there are ‘extra strength’ pills that are 5 mg.

I generally recommend that people start the melatonin at 3 mg per night – and take it about 1 hour before going to sleep. If that doesn’t work, I will sometimes increase the dose from there. Talk to your doctor if you are considering using this approach for your health care.

While I haven’t done any formal research, in my experience with ADHD patients – kids, teens and adults, melatonin seems to help around 50-60% of the time.

There are generally very few side effects with Melatonin usage. If you plan to use it for the longer term, talk to your doctor about any possible risks.

Have you tried melatonin? Does melatonin work for you? Please share your thoughts and experiences below.

Best,

Dr. Kenny

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